Abstract

CANTIN LAHOZ, Víctor et al. Acure renal failure caused by multiple myeloma: care in the hemodialysis unit. Enferm Nefrol [online]. 2014, vol.17, n.2, pp.135-143. ISSN 2255-3517.  https://dx.doi.org/10.4321/S2254-28842014000200008.

Multiple myeloma (MM) is a hematologic malignancy with abnormal proliferation of immunoglobulins and its chains in blood. Renal insufficiency is a frequent and serious complication that can lead to a renal failure in 20 % of cases and may require renal replacement therapy. As it starts with non-specific symptoms, it's important an early treatment to prevent renal damage in order to avoid complications and improve survival conditions. The extracorporeal blood purification techniques using high pore filters or high cut- off (HCO) are very effective because they remove 60-90% of the chains and recover renal function in 50-80% of the cases. Due to the long time sessions characteristics and the treatment complexity, nurses are required an exclusive dedication during the entire process. Methods: 9 patients diagnosed of MM with figures over 500mg/dL light chains treated with HCO filters for at least 6 consecutive sessions of 6 hours. Results: A total of 107 sessions were performed and renal function was recovered in 7 cases. Complications: 18 flow problems, 12 circuit coagulation episodes, 13 fever episodes, 14 hypotension, 13 transfusions, 5 anxiolytic treatment and 7 catheter changes. Conclusions: The long term with haemodialysis HCO filters are effective in removing the light chains and recovering the renal function. The role of nursing is important including a complex technique and giving a human response to the debut of this severe disease.

Keywords : Multiple myeloma; High pore filters; Acute renal failure; Acute kidney injury; Nursing care; Haemodialysis.

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